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Ulcerative Colitis and arthritis - symptoms?

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Ulcerative Colitis
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Posted 3/31/2013 7:33 PM (GMT 0)
I've had UC for 14 years. Prior to that I had back pain (slipped discs). The past few years I have become unable to walk due to arthritis in both knees and painful ankle joints, which give way pretty much every day.
What I need to know is, if you have joint problems and UC, please tell me what your symptoms are?! I have NO rheumatoid factor in blood tests, but do have raised ESR (49) and CRP and white blood count. I feel sure that my joint problems (I'm 43) are related to UC and not simply being overweight. (I've been overweight a long time).
My symptoms are this: clicky knees which get stuck and are often too painful to bear weight. Fizzing of the soles of my feet so standing on them is painful. Weak ankle joints which give way, in the same way as if they are being sprained- a quick sharp pain, and then unable to bear weight. I don't seem to have redness or swelling.
Please tell me if this sounds like UC - related joint pain?! Or is it just wear and tear/old age/ weight related? The ankles don't seem to have arthritis but do have a lot of inflammation in the joint.
ANY help very gladly received! I feel I am a burden to my GP and specialists who say I am hyper mobile, end of. I take no drugs other than ibuprofen, vitamins etc- am intolerant of sulfasalazine.
THANKS smilewinkgrin
Posted 3/31/2013 8:43 PM (GMT 0)
Scarlett, welcome to the forum. I'm sorry you're having problems with your joints. Do you feel that your UC is adequately controlled? What meds are you taking for it?

With UC, you should absolutely not take ibuprofen. I realize it is helpful for your joint pain, but it is contraindicated for anyone with inflammatory bowel disease. You can talk to your GP about other options.

The fact that your ESR and CRP is elevated seems to me to be a red flag that your UC is not well controlled. about 25% of people with IBD have joint pain associated with their illness, so it is not a surprise that you would have joint pain and it be related to your UC. However, it may be hard to distinguish what is going on. I'm glad you have eliminated rheumatoid arthritis as a possible diagnosis, but sorry that you are intolerant of sulfazine (that's what I take to manage my joint pain).

I'm also hypermobile, but it doesn't mean I'm happy about having joint pain related to this. Have you done any physical therapy to strengthen the muscles in your legs to provide better support for your ankles, feet and knees?

You should talk to your GI and/or your rheumatologist about getting to the bottom of the elevated inflammatory markers. Find a treatment protocol for your UC that gets you into remission and perhaps the joint pain will go away. But I think physical therapy is something you should be doing regardless.
Posted 3/31/2013 9:21 PM (GMT 0)
Hi Kazbern,

Well, I haven't had a bad UC flare up for years now. I find it is better if I dont take any drugs for it. I haven't had a bad colon flare up for many years but instead the joint problems seem to have taken over. I have seen two rheumatologists- one said it was Fibromyalgia and the other hypermobility. I disagree with both of these.  What does the sulfasalazine do for you- stop the pain? Do you have actual arthritis in your joints, or just pain? inflammation?

I have had quite a bit of physio but find that the excercises seem to make my joints give way more. I did some flexes this morning of my ankles and shortly after that something went 'ping' and that was that- no more walking today. Both rheumatologists are no longer interested in me as I don't have rheumatoid arthritis. I've never met anyone with UC who also has joint problems- hence coming on here to find out more! I don't think my rheumatologist or GPs have either confused

Posted 3/31/2013 10:07 PM (GMT 0)
If your rheumy doesn't know that UC can come with joint pain, you need a new rheumy.

I do not have arthritis. I have enteritis arthralgia or arthritis - joint inflammation and pain related to my bowel disease. This is not degenerative - it will not damage the joints like rheumatoid arthritis. But for many years it was my primary complaint related to my bowel disease.

Sulfazine is a weird drug in that it actively relieves joint pain and also treats bowel inflammation. If you can't tolerate it, though, then forget about it - it's not for you. You might try a course of steroids to see if that relieves your joint pain. When was the last time you had a c-scope?
Posted 3/31/2013 10:14 PM (GMT 0)
Several years ago now, I ought to have another one, especially as my bowels have altered. I had diarrhoea for many years and in the past year or so I have had more constipation than anything else. Yes, I tried sulfasalazine and it gave me bad stomach cramps but I wonder if there is anything similar. Steroids always stopped my bleeding colon but didn't help my joint pain. Interesting that you have joint inflammation- I am sure that is what is wrong with my ankle joints. Makes me want to try sulfa again. I also take folic acid and vit D, good oil and avoid wheat and dairy. I don't really find that food alters my bowels. I DO get costochondritis though- sternum pain- that's a new one. Hurts if I reach, raise my arms, turn, bend etc. This is, apparently, linked to UC which is why I am certain that it's my UC that;s causing me to be crippled.
Posted 3/31/2013 11:11 PM (GMT 0)
There is nothing similar to sulfazine in the way it treats the bowel and joints simultaneously, unless you start talking about steroids, or other systemic medications that modify the immune system. Many experts feel that treating the bowel inflammation will reduce joint pain. Your blood work shows that there is inflammation somewhere; my bet is that it is in your bowel.

Have you ever taken mesalamines for your UC? Like Asacol?

If you search this forum for joint pain you will see that it is not just you and me with this problem.
Posted 4/1/2013 12:05 AM (GMT 0)
I took Asacol years ago but found that it made my diarrhoea even worse. I stopped it, and all other drugs I'd been given (suppositories etc) and have had hardly any bowel probs since. Very occasional bleeding, steroids a few times. I am willing to try anything though. I had an isotope bone scan which didn't show anything- it's so hard to try and be taken seriously when results like this come back. Only my blood tests show raised ESR/CRP/white blood etc. I feel like I am not taken seriously cos I am overweight and they ALL say "go swimming" as a way to fix all my problems!
Posted 4/1/2013 1:42 AM (GMT 0)
So you are intolerant of mesalamines, which makes UC more complicated to treat. But I encourage you to go to your GI and schedule a scope and talk about how to get your bowel inflammation under control so you can hopefully relieve the joint pain. Not to mention reduce your risk of colon cancer, which is increased if you leave that inflammation untreated.
Posted 4/1/2013 12:49 PM (GMT 0)
I will, thanks for this. I kind of didn't push with the scope cos my bowel has been actually fine for years, it's the joints that are getting so much worse. But as you say, my raised inflammatory markers according to my blood test must be coming from somewhere.
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